Coronavirus: Brain Issues?

On July 7 and July 21, I looked at the health issues that result from coronavirus even after "full" recovery from the virus. Both posts focused on respiratory issues of those who had survived the virus. There are now reports about brain disorders. Both studies come out of the UK.

UCL's Institute of Neurology Study

The Guardian (Jul 8) reports:

Neurologists are on Wednesday publishing details of more than 40 UK Covid-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom.

The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. 



Now just as a comparison: My July 7 and July 21 posts indicated that 10% to 50% of individuals were having lung problems. And that up to 77% of individuals who got lung scans showed damage. The above quote indicates that at this one institute, Adem cases have gone from one a month to two or three a week so let's say 12 a month, at most? This is a huge increase, but considering how many people have gotten infected with the virus in the UK, having a serious brain disorder is less likely than having lung damage. Or is it? The below indicates that individuals just aren't being examined for brain disorders.

The full range of brain disorders caused by Covid-19 may not have been picked up yet, because many patients in hospitals are too sick to examine in brain scanners or with other procedures. “What we really need now is better research to look at what’s really going on in the brain,” [Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust] said.

One concern is that the virus could leave a minority of the population with subtle brain damage that only becomes apparent in years to come. This may have happened in the wake of the 1918 flu pandemic, when up to a million people appeared to develop brain disease.

It is interesting that the 1918 flu also resulted in brain disease.

Neurological Problems in Children

It has widely been assumed that children aren't as impacted by this virus as others. Sure there are the occasional reports of a death, but the fact that these are reported seem to indicate how rare it is for a child to die. There were also reports that children suffered from Kawasaki disease though I haven't heard much follow-up on this so I'm kind of assuming this is also a rare event. Even so, we're still learning more about this virus and so I happened to come across a study on how children are impacted (though once again, we have to wonder at the percentages).

CNBC (Jul 2) reports:

Children diagnosed with Covid-19 pediatric multisystem inflammatory syndrome, or PMIS, may develop new neurological problems without any of the respiratory issues commonly associated with the virus, according to a study published Wednesday in the Journal of the American Medical Association.

Researchers examined 27 children with Covid-19 PMIS, who were previously healthy, between March 1 and May 8 at Great Ormond Street Hospital for Children in London, England. They found that of the 27 patients, four experienced new neurological symptoms.

Now when I initially started reading this article, my thought was, "PMIS sounds like Kawasaki disease. Is this just a different name for it?" The article goes on to say that these are two distinct diseases.

And to close out this blog post, back to the neurological problems for the population in total. The Guardian article pointed out a small study, but then quoted Michael Zandi who said that we needed better research done. I think Zandi may have missed a paper that came out of China that was picked up by those who wrote the study above:

Neurological issues have been previously reported in adults with the coronavirus. The paper cites a different study published in May on the Wiley Online Library that examined 214 coronavirus patients in Wuhan, China. Of those patients, 78 experienced neurological symptoms, which included dizziness, headache, impaired consciousness, acute cerebrovascular disease, seizures and ataxia, which mimics being drunk, with slurred speech and stumbling.

On a percentage basis, that's 36%. That falls in the same range of those who suffer from respiratory problems.